Adding Value, Not Just Finding It

Any personal injury claimant – or even an inexperienced attorney – can simply collect the documentary evidence related to a personal injury claim and submit it to an insurance adjuster for their consideration.  Medical records, medical billings, traffic collision reports, driver DMV records, vehicle damage photographs, wage loss records, receipts for out-of-pocket expenses, etc. — all of these are relevant and important to substantiate a personal injury case, but merely passing on records that have not been thoroughly analyzed, researched, developed, and squeezed of every last drop of value will be shortchanging the injury claim and the injury victim who is seeking compensation. It’s crucial to not only unthinkingly pass on obvious evidence with whatever value is plain on its surface, but to plumb the depths of that evidence, adding value that is not immediately apparent but which is just waiting to be found.

Among the many areas where an experienced personal injury attorney will be able to add value to a client’s claim are in:

• Medical Care, Records, and Billings
• Wage Loss and Loss of Earning Capacity
• Individual Effects on the Personal Injury Victims and Their Families
• Early and Thorough Investigation
• Choosing the Right Experts
• Telling the Injury Victim’s Individual Story

Medical Care, Records, and Billings

The most crucial evidence of a personal injury victim’s losses is typically the diagnosed injuries that he/she suffered, the course of past and future medical treatment necessary to deal with those injuries, and the cost of that past and future medical care.

Obviously, medical care has much greater importance to injury victims than just supporting their injury claims – the victims want to be healed, want their bodies and lives to return to where they were before the auto accident or other incident that caused their injuries.  For this, they want doctors with whom they are comfortable working and who have the professional skill and experience needed to provide excellent medical care.  Very often, these are the injury victim’s own general practice M.D.’s, chiropractors, and/or other primary care doctors with whom they have an established relationship, as well as the specialists these primary care providers know and trust.  Sometimes, however, an individual’s access to the best doctors may be limited by their health insurance plan, by their geographic location, or other factors outside of the injury victim’s direct control.

There are also, however, some excellent doctors who may be discouraged by their medical groups or by a patient’s HMO from providing support to their patients in the “medical-legal” environment of an injury claim and potential litigation.  The bureaucracies behind these organizations are sometimes so averse to engaging with the insurance claim and legal processes that they discourage their physicians from simply saying straightforwardly that “Accident A caused Injury B.”

In these situations where a client may have difficulty getting medical care that is both excellent care and supportive of their claims, an experienced personal injury attorney who is very familiar with the physicians and specialists in their region and with finding options for their clients to receive care from these physicians can add very significant value both to their client’s claims and to the healing benefit of the medical care they receive.

Once the injury victim has received reasonable and necessary medical care for his or her injuries, the next opportunity to add claim value in this area comes from the medical records that have documented the victim’s symptoms, injuries, and treatment.  A thorough review of these records can identify points that need to be explained or highlighted for an insurance adjuster, points of medical-legal proof that need to be further researched and evaluated (such as evidence of prior medical conditions), and/or points of medical concern that the injury victims may want to bring up with their doctors.  Sometimes, a personal injury attorney is the only person other than (hopefully) the victim’s primary care doctor who is reviewing all records pertinent to their client’s injuries and may therefore be in a position to note matters of medical concern that need further evaluation.

Finally, the other documentation resulting from an injury victim’s medical care is the body of medical billings and supporting health insurance claim forms that show the cost of the care that was provided.  For this category of evidence, an experienced personal injury attorney can add significant value for clients by seeking the maximum allowable reimbursement to the client for these costs, proving the fullest value of those billings for injury claims purposes, and by limiting post-settlement reimbursements to med-pay providers and health insurers to the minimum amounts legally required.

Wage Loss and Loss of Earning Capacity

Many folks will suppose that the only wage loss that they can claim as the result of a personal injury is actual bottom-line amounts that they don’t receive on their payroll from time missed at work.  A personal injury attorney can add value for clients by making certain that all categories of losses from time missed at work are compensated for.  This can include vacation time, sick leave, paid time off, or other types of paid leave that the injury victim has chosen (or been required) to use during their time off work.  Another category of compensable loss includes future benefits that accrue concerning hours worked. For example, some employers will have retirement benefit plans for their employees to which the employer makes contributions based upon hours worked.  If contributions of this type are lost due to time missed from a personal injury, they can and should be included in a personal injury claim.

If any of these losses exist but are not clearly detailed in payroll reports that the personal injury victim may routinely receive, then an experienced personal injury attorney will know to request specific reports from the employer that will document these losses.

A personal injury attorney can also add value to the client’s claims for work-related losses that may not have happened yet.  If a client’s doctors believe that there will be elements of either long-term or permanent physical disability, then an experienced personal injury attorney will know to carefully collect and develop evidence through medical reports from the treating doctors, expert reports from disability evaluation experts, vocational rehabilitation experts, and others who can prove these “earning capacity” losses and put specific dollar values on them for purposes of injury claims and/or litigation.

Individual Effects on the Personal Injury Victims and Their Families

In addition to the “economic damages” that an injury victim may sustain for specific dollar-value losses (medical billings, wage loss, earning capacity loss, etc.), the other major element of damages is “non-economic damages” for pain, suffering, loss of consortium for the victim’s spouse, etc.  Some claimants and inexperienced attorneys may just demand a specific dollar value of compensation for these non-economic damages without providing supporting proof or explanation that will convince and compel insurance adjusters to provide full-value compensation in settlement of the claim.

Most personal injury claim insurance adjusters these days are working with software systems designed to automatically evaluate injury claims, and these systems usually focus on specific diagnosed injuries and easily quantifiable information like medical bill totals, time on temporary disability, specific wage loss, and so forth.  These systems do not do a good job evaluating pain and suffering and other non-economic damages, so an experienced personal injury attorney will do the work for his or her clients by highlighting the evidence of these damages for the insurance adjuster.  Much of the evidence can be found by a thorough review and analysis of the medical records.  How often does the injury victim report particular pain symptoms, mobility limitations, or other subjective problems?  What are the reported impacts on the patient’s daily life, work performance, household work, etc.?

Early and Thorough Investigation

Time and preparation are essential elements in developing evidentiary support for a personal injury claim.  An experienced personal injury attorney will be on the ball and collecting traffic collision reports, DMV records, and witness statements to determine just how an auto accident occurred and who the responsible parties (future defendants) may be in terms of driver, owner, employer, etc., for finding all available insurance coverages for a client.

Additionally, the personal injury attorney will work to identify all potential claimants.  Should a loss of consortium claim be brought for the client’s spouse?  If the incident resulted in wrongful death, who are all the possible heirs who must be included under state law?  If other victims in the accident may be bringing claims of their own under the same liability insurance coverage, who are they, and what attorneys may be representing them?

Collecting accident scene photographs, Google Earth overhead photography, vehicle damage photos, and repair reports – along with police reports and witness statements – will help prove just how an accident occurred, just who was responsible for it, and just what the physical forces and dynamics were that the vehicles and injury victims were exposed to.

An experienced personal injury attorney will be adding value for the client in this area by determining just who is or may be making claims, what possible insurance coverages are available to satisfy those claims, how many ways that coverage may need to be divided among multiple claimants, and what the likelihood is of each claim liability being proven.  Knowing this will allow the attorney and client to optimize bottom-line results from the injury claim.

Choosing the Right Experts

In most personal injury claims, evidence provided by the injury victim’s own doctors and employers, by police and DMV reports, and by independent witnesses will provide all the evidence necessary to thoroughly prove their claims.  But in many cases, these items of evidence are insufficient.  What if liability for an auto accident isn’t crystal clear from the police report, physical evidence of the accident, witness statements, and driver statements?  In a contested liability situation, it may be necessary to retain experts such as an accident reconstructionist, vehicle or roadway engineer, or others who can review the available evidence and provide skilled reports and testimony as to what likely occurred.

Some medical situations may also require review and reports by expert witnesses, such as for pre-existing conditions, degrees of permanent disability, long-term prognoses, and other medical concerns and how these items are turned into specific dollar values for litigation by vocational rehabilitation experts, future medical planning evaluators, economists, and others.  Other medical questions may require consultations with medical specialists outside the patient’s own treating doctors who can provide additional expert opinions on the injuries, required treatment, and likely future results.

All these experts come at a cost.  They are highly trained and skilled physicians, engineers, scientists, and other professionals.  An experienced personal injury attorney will be prepared and able to balance the cost of these experts against the significant value they can add to a client’s claim.

Telling the Injury Victim’s Individual Story

Insurance adjusters, defense attorneys, arbitrators, mediators, judges and juries, and sometimes even an injury claimant’s own attorney can become entirely focused on the practical details of the injury victim’s case – it’s mostly right there in the documents, in the medical records, medical bills, police reports, wage loss reports, witness statements, and other items that typically form the body of evidence for a personal injury claim. It’s right there in front of us – we can hold the documents in our hands and read them.

What frequently gets missed here is the injury victim’s own story.  What makes this person unique?  How has this injury affected this person in ways different from how the same injury may impact other people?  What is this person’s individual life story, home situation, and work situation that explain how their injuries have uniquely damaged them?

An experienced personal injury attorney will start from the initial client interview exploring all of this.  What are the client’s individual hobbies and social activities?  Who are the family members they live and interact with daily?  Who does the client know among family, friends, and co-workers who can best observe and describe the injury victim’s daily challenges since suffering their injuries?  All of this will be eventually be turned into a story that can be told at the time of settlement demand, arbitration, mediation, or even trial that can help personalize the injury victim for those folks who will be assessing the impact of the injuries upon their lives to add value in terms of full and complete pain, suffering, and other general damages for their claim.

For more information on insurance companies, their claim tactics, and how an experienced personal injury attorney should deal with them, see:

• Types of Auto Coverage and First and Third-Party Claims
• Insurance Company Tactics: Dirty Tricks Insurance Companies Play in Accident Claims
• Our Tools — How an Experienced Personal Injury Attorney Deals with Insurance Company Tactics
• The Insurance Industry and Individual Companies — Huge and Hugely Profitable

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